Evaluation of Glucocorticoid in Treatment for Patients with Acute Respiratory Distress Syndrome Resulting from Severe Acute Pancreatitis

Objective To evaluate the effect of glucocorticoid(GC)in the treatment for patients with acute respiratory distress syndrome (ARDS) resulting from severe acute pancreatitis (SAP). Methods The clinical data from 25 patients with ARDS resulting from SAP were collected and analyzed. In GC group, GC was given before or after the onset of ARDS 1 to 3 d and the dosage was comparable with methylprednisolone 80 - 500(220.2±139. 6)mg/d. It would be decreased when hypoxemia and shock improved. The therapeutic course lasted 1 to 22 d [average(5. 9±6.2) d]. Results Among 25 cases, 23 (92.0%) received ventilation and 16(64. 0% ) took GC. Organic functional or diabetic complications, and multiple organic dysfunction failure, operation and continual replacement renal therapy in GC group were more than non-GC ( P 0. 05 ) . Their mortality rate was the same( P 0. 05 ) . Their PaO2/ FiO2 and Qs/Qt were improved significantly by GC after 72 h ( P 0. 05). Among 7 cases with refractory shock, 4 (57.1%) were resolved. Conclusion GC would improve refractory hypoxemia and shock in ARDS resulting from SAP. When there were no benefits from ordinary mechanical ventilation and drug therapy, GC should be given without hesitation.